Fecal coliform contamination in child day care environments in Houston, Texas

Outbreaks of diarrhea are common among children in day care centers (DCC). Enteropathogens associated with these outbreaks are spread by the fecal-oral route through contaminated hands or environmental objects. This prospective study was undertaken to determine the prevalence of fecal coliform (FC) contamination in the DCC environment. Ten rooms in 6 DCC housing 121 children $<$2 years of age were studied for 13 weeks. Inanimate objects (1275), toy balls (724), and hands (954) were cultured 1-3 times per week. FC contamination was common during each week of study and was significantly (p $<$ 0.05) greater for objects, toy balls, and hands of children in toddler compared to infant rooms. In 5 rooms in which clothes were worn over diapers, there was a significantly lower prevalence of FC of toy balls (p $<$ 0.005), inanimate objects (p $<$ 0.05), and hands of children (p $<$ 0.001) and caregivers (p $<$ 0.05) when compared to rooms in which overclothes were not worn. Occurrence of diarrhea was significantly associated with increased contamination of caregivers' and children's hands. Using plasmid analysis of trimethoprim (TMP)-resistant Escherichia coli, stool and environmental isolates from individual DCC rooms had the same plasmid patterns, which were unique to each center. In summary, FC of environmental isolates and hands of children and caregivers in DCC is common; toy balls can serve as sentinels of contamination; FC can be significantly decreased by use of clothes worn over diapers; and plasmid analysis of E. coli strains showed the same patterns from stool and environmental isolates. ^

TRANSMISSION DYNAMICS OF ENTERIC BACTERIA IN DAY-CARE CENTERS, HOUSTON, TEXAS

An investigation was undertaken to evaluate the role of fomites in the transmission of diarrhea in day-care centers (DCC) and to elucidate the paths by which enteric organisms spread within this setting.^ During a nine-month period (December 1980-August 1981) extensive culturing of inanimate objects, as well as children and staff was done routinely each month and again repeated during diarrhea outbreaks. Air was sampled from the classrooms and toilets using a Single-Stage Sieve Sampler (Ross Industries, Midland, VA.). Stool samples were collected from both ill and well children and staff in the affected rooms only during outbreaks. Environmental samples were processed for Shigella, salmonella and fecal coliforms while stools were screened for miscellaneous enteropathogens.^ A total of 11 outbreaks occurred in the 5 DCC during the study period. Enteric pathogens were recovered in 7 (64%) of the outbreaks. Multiple pathogens were identified in 3 outbreaks. The most frequently identified pathogen in stools was Giardia lamblia which was recovered in 5 (45%) of the outbreaks. Ten of the 11 (91%) outbreaks occurred in children less than 12 months of age.^ Environmental microbiology studies together with epidemiologic information revealed that enteric organisms were transmitted from person-to-person. On routine sampling, fecal coliforms were most frequently isolated from tap handles and diaper change areas. Contamination with fetal coliforms was wide-spread during diarrhea outbreaks. Fecal coliforms were recovered with significantly greater frequency from hands, toys and other classroom objects during outbreaks than during non-outbreak period. Salmonella typhimurium was recovered from a table top during an outbreak of Salmonellosis. There was no association between the level of enteric microbial contamination in the toilet areas and the occurrence of outbreaks. No evidence was found to indicate that enteric organisms were spread by the airborne route via aerosols.^ Toys, other classroom objects and contaminated hands probably play a major role in the transmission of enteropathogens during day-care center outbreaks. The presence of many enteric agents in the environment undoubtedly explains the polymicrobial etiology of the day-care center associated diarrhea outbreaks. ^

Disparities in foodborne illness in Harris County, Texas, 2005--2010

Using a retrospective cross-sectional approach, this study quantitatively analyzed foodborne illness data, restaurant inspection data, and census-derived socioeconomic and demographic data within Harris County, Texas between 2005 and 2010. The main research question investigated involved determining the extent to which contextual and regulatory conditions distinguish outbreak and non-outbreak establishments within Harris County. Two groups of Harris County establishments were analyzed: outbreak and non-outbreak restaurants. STATA 11 was employed to determine the average profiles of each category across both the regulatory and socioeconomic (contextual) variables. Cross tabulations of all of the non-quantitative variables were also performed, and finally, a discriminant analysis was conducted to assess how well the variables were able to allocate the restaurants into their respective categories. Contextual and regulatory conditions were found to be minimally associated with the occurrence of foodborne outbreaks within Harris County. Across both the categories (outbreak and non-outbreak establishments), variables included were extremely similar in means, and when possible to observe, distributions. The variables analyzed in this study, both regulatory and contextual, were not found to significantly allocate the establishments into their correct outbreak or non-outbreak categories. The implications of these findings are that regulatory processes and guidelines in place in Harris County do not effectively to distinguish outbreak from non-outbreak restaurants. Additionally, no socioeconomic or racial/ethnic patterns are apparent in the incidence of foodborne disease in the county. ^

Tuberculosis in Texas correctional facilities between 2005--2009

It has been well documented that inmates incarcerated in prisons and correctional facilities exhibit higher incidence and prevalence of mycobacterium tuberculosis (TB) disease than the general population. This has public health implications because correctional systems may serve as reservoirs for TB disease that can lead to TB outbreaks in the facilities or can be spread to the general public once inmates are released. Although Texas has one of the largest correctional systems in both the US and the world, little is known about TB prevalence and incidence among Texas inmates. The purpose of this study was to elucidate the relationship between TB incidence and incarceration in Texas correctional facilities and investigate differences in various demographic factors. ^ The study used the national TB database from the US Centers for Disease Control and Prevention (CDC) to calculate and compare the overall incidences of TB disease among correctional facility inmates and similar non-inmates in Texas during 2005–2009. Data were also stratified by age, gender, race/ethnicity, birth status, and HIV status and compared between inmates and non-inmates using chi-squared analysis and relative risks with 95% confidence intervals to assess any significant differences. ^ Results suggest that the overall TB incidence among Texas correctional facility inmates per year (88.6 per 100,000) was significantly higher than that of Texas non-inmates (6.3 per 100,000); a 14 fold difference. Relative risk analyses by gender, race/ethnicity, and those with HIV infection found that the TB incidences for all these demographics were significantly and consistently higher in inmates compared to non-inmates. In particular, Hispanic inmates were more likely to develop TB than their non-inmate counterparts by a relative risk of 23.9 (95% CI 19.4–29.4). Likewise, both male and female inmates were more likely to develop TB than non-inmates (RR = 10.2, 95% CI 8.5–12.2; RR = 20.8, 95% CI 12.2–25.3, respectively), although female inmates unconventionally exhibited a higher TB incidence and relative risk than males inmates, which has not been shown. Among those with HIV infections, correctional facility inmates were 2.6 times were likely to develop TB disease than non-inmates (95% CI 1.5–4.4). ^ Inmates in Texas correctional facilities have a higher incidence of TB than non-inmates. Part of this higher risk may be because a large proportion of inmates come from populations already at high risks for TB, such as foreign born immigrants, those infected with HIV, and low SES groups such as many racial/ethnic minorities. Thus, these results may be used as a basis for more controlled and detailed research in the area, and to further characterize incarceration as a risk factor for TB incidence. They may also bring much needed attention about this health disparity to public health officials, legislators, and health administrators to expand and improve TB control in Texas correctional facilities, particularly among inmates released to the community, and reduce the risk of TB transmission to the general population.^

Dengue transmission risk maps of the continental United States

Dengue fever is a strictly human and non-human primate disease characterized by a high fever, thrombocytopenia, retro-orbital pain, and severe joint and muscle pain. Over 40% of the world population is at risk. Recent re-emergence of dengue outbreaks in Texas and Florida following the re-introduction of competent Aedes mosquito vectors in the United States have raised growing concerns about the potential for increased occurrences of dengue fever outbreaks throughout the southern United States. Current deficiencies in vector control, active surveillance and awareness among medical practitioners may contribute to a delay in recognizing and controlling a dengue virus outbreak. Previous studies have shown links between low-income census tracts, high population density, and dengue fever within the United States. Areas of low-income and high population density that correlate with the distribution of Aedes mosquitoes result in higher potential for outbreaks. In this retrospective ecologic study, nine maps were generated to model U.S. census tracts’ potential to sustain dengue virus transmission if the virus was introduced into the area. Variables in the model included presence of a competent vector in the county and census tract percent poverty and population density. Thirty states, 1,188 counties, and 34,705 census tracts were included in the analysis. Among counties with Aedes mosquito infestation, the census tracts were ranked high, medium, and low risk potential for sustained transmission of the virus. High risk census tracts were identified as areas having the vector, ≥20% poverty, and ≥500 persons per square mile. Census tracts with either ≥20% poverty or ≥500 persons per square mile and have the vector present are considered moderate risk. Census tracts that have the vector present but have <20% poverty and <500 persons per square mile are considered low risk. Furthermore, counties were characterized as moderate risk if 50% or more of the census tracts in that county were rated high or moderate risk, and high risk if 25% or greater were rated high risk. Extreme risk counties, which were primarily concentrated in Texas and Mississippi, were considered having 50% or greater of the census tracts ranked as high risk. Mapping of geographic areas with potential to sustain dengue virus transmission will support surveillance efforts and assist medical personnel in recognizing potential cases. ^

Influenza vaccination as a primary or secondary prevention for cardiovascular diseases: A systematic review of the literature

Background: Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality worldwide. CVD mainly comprise of coronary heart disease and stroke and were ranked first and fourth respectively amongst leading causes of death in the United States. Influenza (flu) causes annual outbreaks and pandemics and is increasingly recognized as an important trigger for acute coronary syndromes and stroke. Influenza vaccination is an inexpensive and effective strategy for prevention of influenza related complications in high risk individuals. Though it is recommended for all CVD patients, Influenza vaccine is still used at suboptimal levels in these patients owing to prevailing controversy related to its effectiveness in preventing CVD. This review was undertaken to critically assess the effectiveness of influenza vaccination as a primary or secondary prevention method for CVD. ^ Methods: A systematic review was conducted using electronic databases OVID MEDLINE, PUBMED (National Library of Medicine), EMBASE, GOOGLE SCHOLAR and TRIP (Turning Research into Practice). The study search was limited to peer-reviewed articles published in English language from January 1970 through May 2012. The case control studies, cohort studies and randomized controlled trials related to influenza vaccination and CVD, with data on at least one of the outcomes were identified. In the review, only population-based epidemiologic studies in all ethnic groups and of either sex and with age limitation of 30 yrs or above, with clinical CVD outcomes of interest were included. ^ Results: Of the 16 studies (8 case control studies, 6 cohort studies and 2 randomized controlled trials) that met the inclusion criteria, 14 studies reported that there was a significant benefit in u influenza vaccination as primary or secondary prevention method for preventing new cardiovascular events. In contrary to the above findings, two studies mentioned that there was no significant benefit of vaccination in CVD prevention. ^ Conclusion: The available body of evidence in the review elucidates that vaccination against influenza is associated with reduction in the risk of new CVD events, hospitalization for coronary heart disease and stroke and as well as the risk of death. The study findings disclose that the influenza vaccination is very effective in CVD prevention and should be encouraged for the high risk population. However, larger and more future studies like randomized control trials are needed to further evaluate and confirm these findings. ^

MOLECULAR AND GENOMIC BASED INSIGHTS INTO THE EVOLUTION OF ENTEROCOCCUS FAECIUM FROM COMMENSAL TO HOSPITAL-ADAPTED PATHOGEN

The basis for the recent transition of Enterococcus faecium from a primarily commensal organism to one of the leading causes of hospital-acquired infections in the United States is not yet understood. To address this, the first part of my project assessed isolates from early outbreaks in the USA and South America using sequence analysis, colony hybridizations, and minimal inhibitory concentrations (MICs) which showed clinical isolates possess virulence and antibiotic resistance determinants that are less abundant or lacking in community isolates. I also revealed that the level of ampicillin resistance increased over time in clinical strains. By sequencing the pbp5 gene, I demonstrated an ~5% difference in the pbp5 gene between strains with MICs <4ug/ml and those with MICs >4µg/ml, but no specific sequence changes correlated with increases in MICs within the latter group. A 3-10% nucleotide difference was also seen in three other genes analyzed, which suggested the existence of two distinct subpopulations of E. faecium. This led to the second part of my project analyzing concatenated core gene sequences, SNPs, the 16S rRNA, and phylogenetics of 21 E. faecium genomes confirming two distinct clades; a community-associated (CA) clade and hospital-associated (HA) clade. Molecular clock calculations indicate that these two clades likely diverged ~ 300,000 to > 1 million years ago, long before the modern antibiotic era. Genomic analysis also showed that, in addition to core genomic differences, HA E. faecium harbor specific accessory genetic elements that may confer selection advantages over CA E. faecium. The third part of my project discovered 6 E. faecium genes with the newly identified “WxL” domain. My analyses, using RT-PCR, western blots, patient sera, whole-cell ELISA, and immunogold electron microscopy, indicated that E. faecium WxL genes exist in operons, encode bacterial cell surface localized proteins, that WxL proteins are antigenic in humans, and are more exposed on the surface of clinical isolates versus community isolates (even though they are ubiquitous in both clades). ELISAs and BIAcore analyses also showed that proteins encoded by these operons bind several different host extracellular matrix proteins, as well as to each other, suggesting a novel cell-surface complex. In summary, my studies provide new insights into the evolution of E. faecium by showing that there are two distantly related clades; one being more successful in the hospital setting. My studies also identified operons encoding WxL proteins whose characteristics could also contribute to colonization and virulence within this species.

INTERACTION OF BACILLUS ANTHRACIS EXOSPORIUM PROTEIN BCLA WITH COMPLEMENT FACTOR H AND SPORE PERSISTENCE IN THE LUNG

Anthrax outbreaks in the United States and Europe and its potential use as a bioweapon have made Bacillus anthracis an interest of study. Anthrax infections are caused by the entry of B. anthracis spores into the host via the respiratory system, the gastrointestinal tract, cuts or wounds in the skin, and injection. Among these four forms, inhalational anthrax has the highest lethality rate and persistence of spores in the lungs of animals following pulmonary exposure has been noted for decades. However, details or mechanisms of spore persistence were not known. In this study, we investigated spore persistence in a mouse model. The results suggest that B. anthracis spores have special properties that promote persistence in the lung, and that there may be multiple mechanisms contributing to spore persistence. Moreover, recent discoveries from our laboratory suggest that spores evolved a sophisticated mechanism to interact with the host complement system. The complement system is a crucial part of the host defense mechanism against foreign microorganisms. Knowledge of the specific interactions that occur between the complement system and B. anthracis was limited. Studies performed in our laboratory have suggested that spores of B. anthracis can target specific proteins, such as Factor H (fH) of the complement system. Spores of B. anthracis are enclosed by an exosporium, which consists of a basal layer surrounded by a nap of hair-like filaments. The major structural component of the filaments is called Bacillus collagen-like protein of anthracis (BclA), which comprises a central collagen-like region and a globular C-terminal domain. BclA is the first point of contact with the innate system of an infected host. In this study, we investigated the molecular details of BclA-fH interaction with respect to the specific binding mechanism and the functional significance of this interaction in a murine model of anthrax infection. We hypothesized that the recruitment of fH to the spore surface by BclA limits the extent of complement activation and promotes pathogen survival and persistence in the infected host. Findings from this study are significant to understanding how to treat post-exposure prophylaxis and improve our knowledge of spores with the host immune system.

Soybean Aphid Efficacy Evaluation

Soybean (Glycine max), grown in Iowa and most of the north central region of the United States, has not required regular insecticide use. The soybean aphid, Aphis glycines (Hemiptera: Aphididae), causes yield losses from direct plant feeding, and has been shown to transmit several plant viruses. In Iowa, soybean aphid can colonize soybean fields in June and has developed into outbreaks in July and August capable of reducing yields by nearly 40 percent.

Soybean Aphid Efficacy Evaluation

Soybean, Glycine max (L.), grown in Iowa and most of the north central region of the United States, has not required regular insecticide usage. The soybean aphid, Aphis glycines (Hemiptera: Aphididae), causes yield losses from direct plant feeding, and has been shown to transmit several plant viruses. In Iowa, soybean aphid can colonize soybean fields in June and has developed into outbreaks in July and August capable of reducing yields by nearly 40 percent.

Composición y distribución del ensamble de Orthoptera (Insecta) en una cuenca árida del norte-centro de Chile

La cuenca del valle del río Elqui (Región de Coquimbo, Chile) es un importante foco de actividad agrofrutícola y turística dentro de la zona norte-centro de Chile cuyas condiciones climáticas se caracterizan por el aumento de la temperatura y la disminución de la precipitación. En el contexto del calentamiento global es esperable que la hoya hidrográfica del río Elqui experimente una tendencia ascendente en la aridez, alteraciones en la fenología de plantas y artrópodos y cambios en la riqueza y biodiversidad local de los ecosistemas. En este sentido, en el presente trabajo, mediante colectas manuales en sectores de secano y cultivo de las localidades de Marquesa, Diaguitas y Pisco Elqui en el valle de Elqui, se documentó la composición taxonómica y abundancia del ensamble de Orthoptera (Insecta) en la cuenca del valle del Elqui, se analizó la distribución espacial de las especies constituyentes del ensamble mediante SIG y se documentó la importancia de Orthoptera como potenciales plagas dentro de esta cuenca árida del norte-centro de Chile. Se capturó un total de 204 ejemplares, correspondientes a cuatro familias y seis especies, de las cuales cinco especies fueron capturadas en sectores de secano y cultivo. Acrididae fue la familia más abundante y diversa dentro de los sitios de estudio (65,2% del total capturado) y Trimerotropis ochraceipennis la especie más abundante dentro del sitio de estudio. Las familias Gryllidae, Ommexechidae y Tristiridae estuvieron representadas por una sola especie. La presencia de estas especies en los sectores de secano puede constituir un factor de riesgo para la agricultura, al considerarse potenciales focos irruptivos frente a determinadas condiciones climáticas, y además ocasionar daños en cultivos agrícolas, plantaciones y pastizales. La relación entre la microdistribución del ensamble de Orthoptera presente en el valle de Elqui y el índice NDVI mostró una clara preferencia por la vegetación densa y poco densa (NDVI = 0,1 - 0,49). El presente trabajo es una primera aproximación al estudio de los ortópteros considerados plagas potenciales para el valle del Elqui.

Chemistry of Globigerinoides ruber shells from ODP Site 160-963

Here we present a high-resolution faunal, floral and geochemical (stable isotopes and trace elements) record from the sediments of Ocean Drilling Program Site 963 (central Mediterranean basin), which shows centennial/millennial-scale resemblance to the high-northern latitude rapid temperature fluctuations documented in the Greenland ice cores between 20 and 70 kyr BP. Oxygen and carbon isotopes, planktic foraminifera and calcareous nannofossil distributions suggest that Dansgaard-Oeschger (D/O) and Heinrich events (HE) are distinctly expressed in the Mediterranean climate record. Moreover, recurrent though subdued oscillations not previously identified in the Lateglacial Mediterranean sediments document a significant centennial-scale climate variability in the basin that is greater than previously thought. Alternations between climate regimes dominated by polar outbreaks during D/O stadials and warm D/O interstadials, with associated intensification of continental runoff, are well expressed in the ODP Site 963. These place the Mediterranean basin as an often overlooked recorder of the interplay between large- and regional- scale climate controls at intermediate latitudes, and of the possible interactions between different components of the climate system. Significant changes in Ba/Ca values measured in Globigerinoides ruber shells from a number of D/O stadials and interstadials suggest enhanced freshwater input from the north-eastern Mediterranean borderland during the D/O interstadials. However, the short duration of 3D stratification events never led to complete oxygen consumption along the water column, but clear effects of sluggish 3D circulation in the basin are testified to by negative excursions in d13C measured in selected species of planktic and benthic foraminifera. HEs are constantly associated with lightening in the d18O record of planktic foraminifera, possibly because of the impact of iceberg melting in the Iberian Margin on Mediterranean thermohaline circulation. Interestingly, in two cases in particular, HE2 and HE5, fresher water inputs also affected deeper horizons of intermediate waters, suggesting a basin-wide impact.

Biogenic and terrigeneous components in ODP Leg 108 holes

Five Ocean Drilling Program sites (657-661), which form a north-south transect off the western periphery of the Sahara, were selected to measure the long-term history of Saharan/Sahelian dust flux and fluvial sediment discharge and the fluxes of marine CaCO3 and opal over the last 8 m.y. Sites 658 and 659 served for high-resolution studies, and Sites 657, 660, and 661 for insights into the spatial patterns of dust flux. The nearshore mean flux of opal off Cap Blanc (21 °N) showed an abrupt increase about 3 Ma that appears to reflect the main onset of coastal upwelling fertility and enhanced trade winds. At the same time, the input of river-borne clay strongly decreased, suggesting a dry up of the central Saharan rivers. Later, marked short-lived spikes of clay and opal may indicate ongoing ephemeral pulses of fluvial runoff linked to peak interglacial stages. Given the zonal dust discharge centered near 18 °N at Site 659, the aridification of the south Sahara and Sahel increased in several steps: at 4.6, 4.3, and especially at 4.0, 3.6, and 2.1 Ma, and again, at 0.8 Ma. The late Miocene and earliest Pliocene were humid. Although the central and north Saharan climate appears to be linked to the glaciation history of the Northern Hemisphere, the long-term aridification further south followed a different schedule. The spatial distribution of quartz accumulation suggests that the dust outbreaks linked to the Intertropical Convergence Zone during summer did not shift in latitude back to 4.0 Ma, at least. The short-term variations of dust output over the last 0.5 m.y. followed orbital scale pulses with a strong precessional signal, showing a link of Sahelian humidity changes to the variation of sea-surface temperature and evaporation in the tropical Atlantic.

Establishment, expansion and regeneration of aspen (Populus tremula) in the Torneträsk area, subarctic Sweden

In subarctic Sweden, recent decadal colonization and expansion of aspen (Populus tremula L.) were recorded. Over the past 100 years, aspen became c. 16 times more abundant, mainly as a result of increased sexual regeneration. Moreover, aspen now reach tree-size (>2 m) at the alpine treeline, an ecotone that has been dominated by mountain birch (Betula pubescens ssp. czerepanovii) for at least the past 4000 years. We found that sexual regeneration in aspen probably occurred seven times or more within the last century. Whereas sexual regeneration occurred during moist years following a year with an exceptionally high June-July temperature, asexual regeneration was favored by warm and dry summers. Disturbance to the birch forest by cyclic moth population outbreaks was critical in aspen establishment in the subalpine area. At the treeline, aspen colonization was less determined by these moth outbreaks, and was mainly restricted by summer temperature. If summer warming persists, aspen spread may continue in subarctic Sweden, particularly at the treeline. However, changing disturbance regimes, future herbivore population dynamics and the responses of aspen's competitors birch and pine to a changing climate may result in different outcomes.

Optical depth of Atlantic dust as netCDF files

African dust outbreaks are the result of complex interactions between the land, atmosphere, and oceans, and only recently has a large body of work begun to emerge that aims to understand the controls on-and impacts of-African dust. At the same time, long-term records of dust outbreaks are either inferred from visibility data from weather stations or confined to a few in situ observational sites. Satellites provide the best opportunity for studying the large-scale characteristics of dust storms, but reliable records of dust are generally on the scale of a decade or less. Here the authors develop a simple model for using modern and historical data from meteorological satellites, in conjunction with a proxy record for atmospheric dust, to extend satellite-retrieved dust optical depth over the northern tropical Atlantic Ocean from 1955 to 2008. The resultant 54-yr record of dust has a spatial resolution of 1° and a monthly temporal resolution. From analysis of the historical dust data, monthly tropical northern Atlantic dust cover is bimodal, has a strong annual cycle, peaked in the early 1980s, and shows minimums in dustiness during the beginning and end of the record. These dust optical depth estimates are used to calculate radiative forcing and heating rates from the surface through the top of the atmosphere over the last half century. Radiative transfer simulations show a large net negative dust forcing from the surface through the top of the atmosphere, also with a distinct annual cycle, and mean tropical Atlantic monthly values of the surface forcing range from -3 to -9 W/m**2. Since the surface forcing is roughly a factor of 3 larger in magnitude than the top-of-the-atmosphere forcing, there is also a positive heating rate of the midtroposphere by dust.